These larger lesions contribute to more severe symptoms. In MS, the areas of damage are generally short. People with NMOSD have lesions on their spinal cord that are longer than those found in MS, often extending along several segments of the spinal cord, says Dr. Lesions on the Spinal Cord Are Much Larger The reason people with NMOSD have uncontrolled nausea, vomiting or hiccups, for instance, is because there's damage to the area postrema on the brainstem, explains Dr. Meanwhile, the damage associated with NMOSD is focused on the optic nerve, brainstem, and spinal cord. This includes the optic nerves, spinal cord, and all parts of the brain: the cerebellum (which manages balance and coordination) the brainstem (the lower part of the brain that regulates numerous vital functions, including swallowing and breathing) and the cerebrum (which controls everything from memory, problem solving, and learning to walk), continues Dr. “MS damages the entire central nervous system,” says, Dr. Damage Tends to Cluster in Certain Parts of the CNS Visual field defects, like spots, are rare with MS. With MS, vision difficulties usually occur in just one eye, and they often improve once inflammation abates. You can also develop severe pain when you move your eyes, or a stabbing pain in the back of your eye. Your vision may be blurry, colors may appear washed out, you may lose vision in the upper or lower half of your visual field, or you may temporarily or permanently go blind in one or both eyes. That’s why the damage to vision can be bilateral. Often NMOSD affects the part of the brain where the two optic nerves-one from each eye-connect, referred to as the optic chiasma. Vision loss can occur with NMOSD because of severe inflammation of the optic nerve (optic neuritis), which impairs the proper transmission of nerve impulses from the back of the eye (retina) to the visual center of the brain. With MS, having nausea, vomiting or hiccups that won't go away is rare. Rather, they are extremely severe and constant, and affect your ability to go about your daily activities. (Or you may have hiccups that don’t abate for weeks on end.) These gastrointestinal (GI) symptoms are not your run-of-the-mill indigestion, reflux or nausea that can readily be resolved with an OTC drug.
“The first symptom of NMOSD may be uncontrollable nausea and vomiting for weeks,” says Sean Pittock, M.D., director of Mayo Clinic's Center for Multiple Sclerosis and Autoimmune Neurology and the Neuroimmunology Research Laboratory in Rochester, MN. If something were to damage the astrocytes, depending on the location and the extent of the damage, it can result in anything from difficulty walking to blindness.Ģ. One of their most important functions is to deliver energy to neurons and to kickstart the release of neurotransmitters, chemicals that allow the neurons to communicate with each other. And they don't attack all the AQP4 proteins in your body, only the ones present in nerve cells called astrocytes.Īstrocytes are nerve-cell caretakers that live in the brain and spinal cord. Instead, specialized proteins called antibodies attack AQP4, a key protein that regulates how water moves in and out of cells. However, with NMOSD, it’s not T-cells that have gone awry. T-lymphocytes) attack myelin, the sheaths that wrap around long nerve fibers (normally these immune cells destroy invading bacteria and viruses). Though both MS and NMOSD involve the body attacking itself and both result in inflammation, what’s doing the attacking and what’s being primarily attacked differs between the two conditions. Turns out, NMOSD is distinctly different. With such similar symptoms, it took more than a century (really!) for scientists and physicians to realize that NMOSD wasn’t just a spoke of the MS umbrella.